Question

Appraise the evidence-based practices related to the nutritional needs of pregnant women with gestational diabetes

• Identify two ways in which good blood glucose control during the periconceptional period can benefit fetal growth and development

• Define the different, major types of disorders in carbohydrate metabolism that occur during pregnancy and identify the key components of the nutritional management of each type.

Answer 1

The periconceptional period is a month as 5 to 6 months when women oocyte or fetus grow, during this period there is an epigenetic modification that occurs for normal development. There will be a risk for maternal glycemia that increase maternal insulin resistance related to hormonal changes. More glycemia levels, maternal insulin resistance increase amino acids, and fatty acids so these nutrients stimulate fetal insulin secretion and growth. Major risk factors of maternal obesity during pregnancy increase pregnancy glucose levels. women with diabetes during pregnancy should be treated for diabetic retinopathy, neuropathy, depression, and thyroid disease. There are many ways to women with periconceptional diabetics they can control their glucose level. Regular physical examination, weight management, assessment of ophthalmologic dilated retinal exam, DM treatment regimen to target the pregnancy glycemic target range, dietary followup, healthy lifestyle, and its modification, exercise can keep the glucose level under control, hence it benefits fetal growth and development.
Gestational diabetes mellitus: It occurs during pregnancy by increasing blood glucose level high and usually disappear after delivery.
Impaired glucose tolerance is a prediabetic period that increases the risk of developing diabetic complications like cardiovascular disease, premature rupture of membrane, preterm birth, etc. It indicates blood sugar higher 140-199 mg/dl after 2 hours of OGTT.
Gestational diabetes and impaired glucose tolerance during pregnancy as a first-line treatment nutrition therapy support fetal metabolic needs and maternal needs. It includes avoiding high-fat diet and lowering carbohydrate diet because maternal triglycerides and free fatty acids used by the placenta incorporate to fetal fat than maternal glucose. Diet and insulin will be an effective way to reduce maternal glucose.